Minimally Invasive Splenectomy for Recurrent Gynecologic Cancer and Long-Term Outcomes
Journal of Minimally Invasive Gynecology, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.jmig.2026.08.018
- Dergi Adı: Journal of Minimally Invasive Gynecology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
- Anahtar Kelimeler: Laparoscopic splenectomy, Minimally invasive surgery, Recurrent ovarian cancer, Robotic splenectomy, Secondary cytoreduction
- Süleyman Demirel Üniversitesi Adresli: Evet
Özet
Study Objective: To evaluate the surgical safety, feasibility, and long-term oncologic outcomes of minimally invasive (MIS) splenectomy in patients with isolated or oligometastatic recurrence of gynecologic malignancies. Design: Retrospective single-institution cohort study (AAGL Classification of Evidence: II-3). Setting: Tertiary academic referral center (Mayo Clinic, AZ). Patients: Ten consecutive women with platinum-sensitive recurrent gynecologic cancer (6 ovarian, 2 endometrial, 2 cervical) involving the spleen or left upper quadrant. Eight patients had pathologically confirmed recurrent gynecologic malignancy; in 2, pathology revealed nongynecologic disease (necrotizing granuloma; B-cell lymphoma). The primary oncologic analysis was restricted to the 8 confirmed cases. Interventions: MIS splenectomy (laparoscopic, n = 6; robotic, n = 4) for secondary or tertiary cytoreduction, with concomitant procedures when needed for complete resection. Measurements and Main Results: All procedures were completed minimally invasively without conversion. Median operative time was 202 minutes (IQR 196.5–211.5; range 108–325) and median estimated blood loss was 50 mL (IQR 50–125; range 20–450). No intraoperative complications occurred. Postoperative complications were limited to Clavien–Dindo grade I to II; median Comprehensive Complication Index was 11.2. Median hospital stay was 42 hours (IQR 25.5–72.25). R0 resection was achieved in 10/10 patients (100%). In the primary analysis (n = 8), at a median follow-up of 53.8 months after splenectomy, 1 patient developed recurrence at 78.5 months and no patient had died; 5-year overall survival and 5-year disease-free survival were both 100% (exact 95% CI 39.8%–100%). Survival estimates should be interpreted cautiously given the small sample size. Conclusion: In this highly selected cohort treated at a tertiary referral center, MIS splenectomy appeared technically feasible and short-term safe and was associated with favorable observed oncologic outcomes. These findings support feasibility but do not establish causal oncologic efficacy.